28 June 2011

In this June 11, 2011 file photo, Lance Cpl Blas Trevino from 1st Battalion, 5th Marines, left, gestures towards his troops as he holds onto a gunshot wound in his belly while running towards a medevac helicopter from the US Army's Task Force Lift "Dust Off", Charlie Company 1-214 Aviation Regiment after he got shot in the stomach, outside Sangin, in the Helmand Province of southern Afghanistan. AP Photo/Anja Niedringhaus.

Associated Press photographer Anja Niedringhaus traveled with an Army "Dustoff" MEDEVAC unit for two weeks in Afghanistan's Helmand province. From her first-person account of one dangerous day:

I heard a metallic sound and realized the helicopter had been hit.

The pilot, Chief Warrant Officer 3 Dan Fink, quickly pulled the helicopter's nose toward the sky. All I could see in front of us were trees and power lines.

"If we are going to crash. I don't want to see it," I thought. My eyes shut, I held onto my seat belt.

I opened my eyes. We hadn't crashed. Slowly, the helicopter gained altitude and rose to safety.
...

After 15 minutes, I realized we would return to the same spot. As I looked at Campbell, I noticed his extraordinary level of concentration. He adjusted his gloves, reached for his assault rifle and then peered out of his open window.

I kept trying to find my lucky charms in my pockets.

The helicopter touched down right where we took fire only minutes earlier. The big side door slid open. I reached for my camera, feeling better because I could concentrate on something else.

Campbell jumped out first. He looked around. Neither of us could see the Marines. Suddenly, a Marine jumped up from a ditch nearby, one hand on his stomach and the other holding rosary beads.

The Marine sprinted toward us, turning around to wave to the others that he could make it to the helicopter. Another Marine tried to catch up to help him, but the injured Marine, Lance Cpl. Blas Trevino from 1st Battalion, 5th Marines, ran so fast he made it to the helicopter first.

Trevino latched onto Campbell in a desperate hug.

"You have made it! You have made it!" Campbell shouted over the whine of the idling helicopter.

24 June 2011

Navy Lt.j.g. Haraz Ghanbari follows the Soldier featured in this post, Pfc. Shawn Williams, from Point of Injury to treatment at the NATO Role 3 Multinational Medical Unit at Kandahar Air Field.

Pfc. Shawn Williams of the 1st Stryker Brigade Combat Team, 25th Infantry Division based in Fort Wainwright, Alaska, is taken to a Black Hawk helicopter for evacuation after being injured by a roadside bomb, Friday, June 17, 2011, in the Kandahar province of Afghanistan. Photo: Navy Lt.j.g. Haraz Ghanbari.

KANDAHAR AIRFIELD, Afghanistan, June 22, 2011 -- An air ambulance crew from Company C, 1st Battalion, 52nd Aviation Regiment, just finished their lunch in a small break room in southern Afghanistan when a nine-line medical evacuation, or medevac, request was received.

The time was 1:51 p.m., and within a matter of seconds the Soldiers, who are deployed from Fort Wainwright, Alaska, ran a couple of hundred yards to two Black Hawk helicopters.

As the co-pilot and crew chief prepared their helicopter for the critical mission, the pilot and medic were inside the tactical operation center getting grid coordinates and information on the patient. Another couple of minutes passed, and the pilot and medic headed to the helicopter to suit up.

Roughly 10 minutes lapsed since the initial request was received, and the helicopters were now airborne en route to Sha Wali Kot.
Pfc. Shawn Williams, 1st Stryker Brigade Combat Team, 25th Infantry Division, also based in Fort Wainwright, was driving a Stryker vehicle when a roadside bomb detonated and ignited the vehicle on fire. Williams’ foot was fractured, his face covered with hot grease, his right and left hands suffered second-degree burns and were blistering.

As flames engulfed the Stryker and thick black smoke filled the blue Afghan sky, Williams’ battle buddies stabilized him, wrapping his right hand in gauze and providing support to his right foot, while relaying information to the incoming medical evacuation crew. Two Kiowa Warrior helicopters circled overhead providing firepower and checking for additional enemy threats as the medevac pilots made a final approach to the landing zone.

“At the POI [point of injury], the first thing I was concerned about was the security of the pick-up location. Secondary IEDs [improvised explosive devices] targeting the medevac helicopter are a very real threat for us, so we are always looking below and around the helicopter,” explained Sgt. Daniel Sherwin, the onboard flight medic. “A captain approached me and briefly told me the injuries of the patients, and their medic gave me a quick run down of the treatment.”

The nine-line medevac request only noted one patient, but Sherwin learned after landing that another Soldier sustained a possible traumatic brain injury.

Four Stryker Soldiers carried Williams on a litter toward the helicopter, its blades still turning as it sat within eyesight of the damaged Stryker -- ammunition exploding inside from the intense heat. Sherwin, a Canadian citizen who has been in the U.S. Army for seven years and is on his second combat tour, walked alongside Williams doing an initial assessment of the patient.

Almost 20 yards from the door of the helicopter, Williams, raising his left hand -- blackened from grease -- gave his unit the thumbs-up.

Once loaded into the helicopter, the pilots lifted off quickly over the hills and mountains as Sherwin began a more complete evaluation. From head to toe, he checked Williams’ injuries -- making sure his airway was clear, he was breathing OK and that he wasn’t bleeding.

“We got the guys loaded as quickly as possible and took off,” said Sherwin. “One of the biggest things we have to offer is speed, so getting off the ground and on our way to the hospital is essential.”

Sherwin needed to remove Williams’ improved outer tactical vest, a specially designed piece of equipment used to protect servicemembers from various types of war-zone hazards such as shrapnel and different types of ammunition. The vest and its components, typically weighing between 30 to 35 pounds, is at times cumbersome to remove so Sherwin pulls a lanyard attached to the vest causing it to quickly fall apart into four pieces so the triage can continue.

Williams is a priority patient known as “Category A,” because of the potential for loss of life, limb or eyesight.

Pfc. Shawn Williams of the 1st Stryker Brigade Combat Team, 25th Infantry Division, based in Fort Wainwright, Alaska, right, is treated by flight medic Sgt. Daniel Sherwin en route to the Kandahar Airfield NATO Role 3 Multinational Medical Unit for additional treatment after he was injured by a roadside bomb, Friday, June 17, 2011, in the Kandahar province of Afghanistan. Sherwin is assigned to the Charlie Company, 1-52 Aviation Regiment, also based in Fort Wainwright. Photo: Navy Lt.j.g. Haraz Ghanbari.

“I was very concerned about his airway, because inhalations burns will cause swelling,” said Sherwin. “I looked in his nose and mouth to see if there were any signs of burns, and was relieved to not see any.”

Cutting off Williams’ combat shirt and pant legs, Sherwin takes a pulse and starts an IV while monitoring other vital signs.

Due to the noise and vibration of the helicopter it can be difficult to monitor a patient’s breathing, but Sherwin says looking at and feeling the rise and fall of the chest works well.

“The second patient was clearly shaken by the incident, but was in stable condition. He was concerned about his buddy,” said Sherwin. “I quickly got some vital signs on him to be sure he was as stable as he appeared to be. Simply giving them a thumbs up and getting one in return is reassuring to both us and the patient.”

Back on Kandahar Airfield, a distinct series of high-pitched tones alerting the medical staff of an inbound “Cat. A,” cuts through the chatter of nurses and doctors tending to patients at the NATO Role 3 Multinational Medical Unit.

Within moments, a small group of hospital corpsman who comprise the emergency vehicle operator course, or EVOC, team quickly gather their protective helmets and goggles as they reach for their pagers to read the short description of the inbound patients’ wounds.

Climbing into the rear of a specially designed humvee ambulance, the head of the afternoon’s EVOC team radios the hospital’s tactical operations center for an update. The ride from the trauma bay to the flight line is short, but long enough to discuss any critical information about the patient.

Sometimes the patient is stabilized, but other times the corpsmen may need to assist with rending continuous medical treatment until a nurse or doctor takes over in the trauma department.

Pulling up to the edge of the flight line, the driver positions the humvee as the helicopter pilot makes a fast approach to the landing zone. The rotor wash is so strong the corpsmen brace themselves against the side of the humvee until the helicopter has landed, a technique they use to prevent from being blown over.

Two by two, the corpsmen carefully move toward the side of the Black Hawk as Sherwin opens the door. Two corpsmen carry the “head” or top of the litter and two carry the “feet” or bottom of the litter.

The time is 2:51 p.m., and Williams and the second patient are loaded into the ambulance, as a hospital corpsman and Sherwin accompany them. The corpsman radios ahead, and roughly 45 seconds later the team unloads Williams, securing him to combat gurney before another team from the trauma department takes over.

Once inside the trauma bay, Sherwin quickly briefs a team of U.S. Navy doctors, nurses and corpsmen along with medical professionals from other countries who then begin more advanced treatment.

“We brief them [the trauma team] on the mechanism of injury, injuries sustained that we have found, all the vital signs, and all the findings in our assessment, to include the status of their bleeding -- controlled or not controlled -- airway, breathing and the level of consciousness,” explains Sherwin. “Lastly we tell them all the treatments that were done for the patient, and again include what the ground medic did and what we did for the patient in the air -- medications administered and the time and dose given is also important for them to know.”

For Williams and his battle buddy, the transfer of care from field medic to flight medic and then to the trauma team occurred within what is known as the “Golden Hour.” Medical professionals have determined that if a critically injured patient receives definitive treatment within 60 minutes from the time of injury, his or her chances for survival increase dramatically.

As part of the transfer of care Sherwin says that all of the information the medevac crew relays is particularly important if the patient is unresponsive, but if the patient is alert and oriented -- talking to the doctors and not in any apparent distress -- the doctors typically can gather a great deal about the patient’s general condition.

After various tests and treatments, approximately six hours have passed since Williams arrived at the Role 3, and he is recovering in a room with other servicemembers. It’s nearly 9 p.m. and Williams receives a visit by the chief of staff and command sergeant major for International Security Assistance Force Regional Command South and 10th Mountain Division (Light Infantry).

The 21-year-old Soldier, his face now free from grease, his foot better stabilized and his burns beginning to heal, recalls his escape from the burning Stryker and his medevac flight to the hospital.

A 25-year Army veteran, Col. Erik C. Peterson, the chief of staff, requests for the orders to be read awarding Williams the Purple Heart for wounds received in action. As other servicemembers stand at attention, Peterson clips the medal to a white blanket Williams is using to keep warm.

Peterson asks Williams about his family and his unit, and then the three share a few laughs. Prior to departing, Command Sgt. Maj. Christopher Greca, himself a Purple Heart recipient, presents Williams with a command challenge coin.

For the next several hours, Williams rests under the observation of a nurse and corpsman before departing for Landstuhl Regional Medical Center in Germany for additional treatment en route back to the United States. At 4:25 a.m., Williams is discharged from the Role 3 for the next chapter of his recovery.

Stories similar to Williams’ occur everyday at the Role 3 with patients arriving by medevac or sometimes ambulance. Injuries range from debris in a person’s eyes to a servicemember who has suffered a catastrophic injury such as the loss of multiple limbs.

Patients can include coalition servicemembers, Afghan national security forces, local nationals as well as military contractors.

23 June 2011

U.S. Army Pfc. Shawn Williams gives the thumbs-up to members of his unit as he is evacuated after being injured by a roadside bomb in Kandahar province, Afghanistan, June 17, 2011. Williams is assigned to the 25th Infantry Division's 1st Stryker Brigade Combat Team. U.S. Navy photo by Lt. j.g. Haraz N. Ghanbari.

21 June 2011

(CBS News) BETHESDA NAVAL HOSPITAL, Md., - The war in Afghanistan now in its tenth year. And the fighting is more intense than ever. The latest Pentagon survey of combat troops found more are getting into firefights and facing IED attacks.

The number of wounded Americans grew steadily each year since 2001. Then last year, they more than doubled after President Obama's surge - which added 30,000 U.S. troops.

The battlefield wounded arrive at Andrews Air Force Base outside Washington. Marines, all of them from Afghanistan, are taken to Bethesda National Naval Medical Center. If you visit them you can find out exactly what the fighting is like in the Taliban heartland of southern Afghanistan.

How often would you go out on patrol and end up in a firefight?

"You could almost set your watch to it. Every day," Sgt. Jason Ross tells CBS News national security correspondent David Martin.

Ross was done in not by an enemy bullet, but by 10 pounds of homemade explosives which tore off almost half his body when he took the last step he probably will ever take.

Ross's unit would find as many as 15 so-called improvised explosive devices a week, which explains why more than 60 percent of combat troops in Afghanistan have had a close call from an IED.

Lance corporal Ryan Bochberger remembers the first IED he stepped on. "It was a 40 pound pressure plate but it didn't go off because it was made for a truck."

Bochberger lost three buddies to IEDs. One of them, Sergeant Sean Callahan was buried at Arlington Cemetary on the day the rest of the country cheered the killing of Osama Bin Laden.

Seventy-three percent of combat troops in Afghanistan have lost a member of their unit.

Watch the video of David Martin's interviews with recovering Marines at Bethesda.

Three times a week an ambulance bus arrives at Bethesda carrying wounded Marines from Afghanistan, via Landstuhl hospital in Germany. Before the surge in Afghanistan, there would have between 20 and 30 patients at any one time. Now, there are between 30 and 50.

11 June 2011

Lance Cpl. Blas Trevino of the 1st Battalion, 5th Marines, clinches onto his Rosary beads as he is rescued onto a medevac helicopter from the U.S. Army's Task Force Lift "Dust Off", Charlie Company 1-214 Aviation Regiment after he got shot in the stomach outside Sangin, in the Helmand Province of southern Afghanistan, Saturday, June 11, 2011. The Army's 'Dust Off' crew needed two attempts to get him out, as they were fired upon and took five rounds of bullets into the tail of their aircraft. (AP Photo/Anja Niedringhaus)

09 June 2011

First Person Combat: In a Minefield is today's must-read from the NYT's At War blog, written by James Dao. The piece recalls the events which took place last fall on a small hilltop in Afghanistan's Kunduz province. Soldiers of Alpha Company, First Battalion, 87th Infantry, 10th Mountain Division tell the story.

As Specialist Gannon explains, death and injury in war can seem maddeningly capricious. Why had other soldiers stepped in the same area and not set off the mine, they asked each other. Was it because Specialist Hayes carried a heavier load, including a machine gun? Had others actually stepped on the edges of the mine, but just missed its trigger? Was it a foreign-made plastic mine? Or a devilishly simple homemade device built from fertilizer and soda bottles?

An earlier blog post suggests some of the possible reasons the detectors missed the mines. But the soldiers will never know.

What is clear in the video is the response to Specialist Hayes’ injury. Sgt. First Class Dean Lee can be heard urging a senior medic, Sgt. Jerry Price, to move to the wounded soldier (Sergeant Price described his experience on the hill in a separate video). Later, Specialist Gannon steps alongside Specialist Hayes and the camera captures the calming voices of Sergeant Price as he administers morphine and the jokes of Sergeant Lee as he grips Specialist Hayes’ hand.

Sergeant Lee would win a Bronze Star with Valor for his actions on the hill that day, which also included leading medics to Petty Officer Kremer.

As the video closes, Specialist Hayes is loaded onto a stretcher to be carried to a helicopter landing zone at the base of the hill. “Be careful,” the specialist, in obvious pain, tells Specialist Gannon. “Why, you think I’ll drop you, bro?” Specialist Gannon replies. “No, getting out of here, man,” Specialist Hayes says.

This video contains images of violence and graphic language.

The video above is an edited version of helmet cam video taken by Specialist Michael Gannon. It "captures the eerie suddenness of the explosions, and, in the case of Specialist Hayes, the efforts of his platoon sergeant and two medics to aid and comfort him. What it does not quite capture are the raw emotions of the soldiers: the nervousness many felt climbing the hill, their anger and frustration after the explosions."

07 June 2011

Army Spc. Jenny Martinez holds the hand of an injured Marine who was wounded in an IED strike onboard a medevac helicopter from the Army's Task Force Lift "Dust Off", Charlie Company 1-214 Aviation Regiment near Sangin, in the Helmand Province of southern Afghanistan, Saturday, June 4, 2011. AP photo by Anja Niedringhaus.

06 June 2011

Zane Schlemmer, a veteran U.S. Army paratrooper who jumped into northern France as a sergeant with the 82nd Airborne Division, walks in his jump boots down the main street of Sainte Mere Eglise with other World War II veterans during the 67th anniversary of the Allied invasion of France, June 5, 2011. French citizens applaud as he and current paratroopers with the 82nd and other Army units parade past. (U.S. Army photo by Sgt. Michael J. MacLeod)

Here's a video clip from last year's march to give you a feel for the atmosphere during the annual anniversary commemorations.

U.S. military color guard, German military band, U.S. Army Airborne Soldiers, German Special Operations soldiers, British soldiers, followed by the townspeople of Sainte Mère Eglise, Normandy, France march into the town square to honor the heroes of D-Day, June 6th, 1944. (June 6, 2010)

05 June 2011

Then-Staff Sgt. Joseph Kapacziewski is shown gearing up as a Ranger squad leader for a mission in Afghanistan. Kapacziewski, who lost his right leg after an October 2005 blast in northern Iraq, has deployed four times to Afghanistan as a below-the-knee amputee. Photo: US Army.

When Sgt. 1st Class Joseph Kapacziewski decided to have his right leg amputated, he had one goal in mind: to return to the line and serve alongside his fellow Rangers.

It took months of hard work and painful rehabilitation, but Kapacziewski achieved his goal and has deployed four times to Afghanistan as a below-the-knee amputee.

He was presented with the No Greater Sacrifice Freedom Award on May 24 in Washington, D.C.

Honored alongside Army Chief of Staff nominee Gen. Ray Odierno, the commander of Joint Forces Command and former commander of U.S. troops in Iraq, Kapacziewski is the first noncommissioned officer to receive the award, which recognizes individuals who epitomize selfless service to the nation.

“It’s a little embarrassing,” Kapacziewski said about being singled out for the honor. “Everyone here in the regiment is a team player, so being recognized as an individual is a little awkward.”

Kapacziewski, 28, joined the Army more than nine years ago and has served with the 75th Ranger Regiment since May 2002.

Wounded in October of 2005, Kapacziewski chose to have his damaged leg amputated in March 2007.

Ten months after his amputation, Kapacziewski completed an Army PT test, a five-mile run and a 12-mile road march while carrying 40 pounds of gear.

In March 2008, one year after his surgery, Kapacziewski accomplished his goal. He was put back on the line, as a squad leader in A Company, 3rd Battalion, 75th Ranger Regiment.

He has deployed four times to Afghanistan since he was wounded in 2005; he came home in mid-May from his most recent four-month tour.

In between all of that, he completed the Maneuver Senior Leader Course, and Ranger Assessment and Selection Program II.

He is now a platoon sergeant in 3rd Battalion’s C Company.

Deploying again was “a dream come true,” Kapacziewski said, but he also admits that, at first, he was nervous about deploying with a prosthetic.

“I did worry about it a little bit, sort of being so far away from anyone who could help me with my prosthetic if I started having issues with it,” he said. “But it just meant taking care of my residual limb and taking care of the prosthetic.”

Kapacziewski has three identical prosthetics for everyday use and one for running.

“My prosthetist does a real good job fitting me and lining everything up perfectly,” he said. “We were able to find one that was very universal where I can run, skip and jump out of airplanes.”

Kapacziewski said his fellow soldiers don’t even notice anymore that he wears a prosthetic.

“The first few months walking around, a lot of people would do double takes,” he said. “I had a lot of pressure on my shoulders, wanting to prove I could do anything everyone else could. Over the years, nobody gives it a second thought anymore.”

Kapacziewski said he hopes that more wounded soldiers like him, who want to continue serving, will be given the chance to do so.

“When you put your mind to something, you can accomplish it,” he said. “For the guys who are getting hurt, just because they get hurt, they can still have a huge impact on not only their soldiers but the Army in general. A lot of the guys who get injured have a lot of combat experience that can be passed on to other people. A lot of it is giving them the time to do the rehab to get better so they can go back to doing what they want to do.”

Kapacziewski said he has a simple answer when people ask him why he stayed in uniform and continues to deploy.

“It’s all about the guys you work with,” he said. “I feel like I have the privilege to come to work with my 600 best friends every day, and they have the strongest desire to close in and destroy the enemy. And that makes it all worthwhile.”

04 June 2011

Palo Alto — Marine Lance Cpl. Jorge Ortiz, 19, of Fresno, who was critically injured in an explosion in Afghanistan, rests at the Polytrauma Rehabilitation Center at the Department of Veterans Affairs hospital in Palo Alto, where physicians and therapists take a team approach to care for those who have suffered catastrophic injuries. Photo: Mark Boster / Los Angeles Times.

"Despite your injuries, you're still a Marine and the Commandant has ordered you to cooperate with the doctors and therapists and get back in the fight."

Tony Perry of the LA Times has done some terrific reporting about the 3/5 Marines, and this is his latest from the Polytrauma Rehabilitation Center at the Department of Veterans Affairs hospital in Palo Alto.

Palo Alto has the only VA polytrauma unit on the West Coast. Others are at VA hospitals in Tampa, Fla.; Minneapolis; and Richmond, Va. — all care for both active-duty and medically retired personnel.

The Palo Alto unit has a staff of medical specialists and an agreement with nearby Stanford University School of Medicine. There are specialists in amputation, auditory impairments, blindness, spinal cord injuries, and post-traumatic stress disorder and other mental health conditions.

Here, mending bodies is only one piece of the puzzle.

Recently, the 19-year-old [Marine Lance Cpl. Jorge] Ortiz suffered a complication common to new amputees: leg bone growth protruding through one of his stumps.

Ortiz, who grew up in Los Angeles before his family moved to Fresno, underwent surgery to remove the growth so he could resume the long, difficult ordeal of being fitted with prosthetic legs and learning to walk.

But the surgery has left Ortiz in enormous pain.

His doctors have given him a variety of medications that leave him foggy and could slow down his recovery from another of his wounds: traumatic brain injury.

Although he lacks a visible head wound, Ortiz has the slowed responses and memory difficulties common to troops damaged by the blast of roadside bombs that are the Taliban's weapon of choice.

"Can my pain medications go up?" Ortiz asked one of his doctors during a bedside visit.

"You're basically on everything known to medicine," Scott replied. "It's one of the things that make me sad to be a doctor: We can't fix everything."

It's a dilemma for doctors and patients: medication can dull, although not eliminate, pain but they also can delay recovery from traumatic brain injury and other wounds.

Still, Ortiz has some advantages. He is known among the medical personnel for his determination.

Palo Alto — Ortiz gazes into a mirror in the physical therapy room at the Veterans Affairs hospital in Palo Alto, one of four such specialized trauma centers nationwide. A combat photographer, he was taking pictures of a captured weapons cache in Sangin, Afghanistan, on Jan. 15 when he stepped on a buried explosive device. Photo: Mark Boster / Los Angeles Times.

Read more about LCpl. Ortiz's fight and that of one of his fellow patients, Cpl. Farrell Gilliam.